Skip to content
2000
  1. Home
  2. A-Z Publications
  3. Reviews on Recent Clinical Trials
  4. Fast Track Articles
  5. Fast Track Article
image of The Efficacy of Two Triple Therapy Regimens and One Quadruple Regimen [Omeprazole, Amoxicillin, Metronidazole with Bismuth] in Eradicating Helicobacter Pylori in Patients with Peptic Ulcer: A Randomized Clinical Trial

Abstract

Background

infection is the main cause of most PUD; therefore, the eradication of is extremely important in the treatment of PUD. There are several recommended treatment regimens suggested to eradicate this organism.

Aim

This study compared the efficacy of three anti- regimens in patients with dyspepsia or peptic ulcer disease [PUD].

Objective

The objective of this study was to assess the efficacy of three anti- treatments in patients based on C14 urease breath test [C-UBT] results, drug compliance, and adverse effects.

Methods

This randomized, open-label clinical trial included 136 -infected patients without prior treatment. Patients were randomly divided into three groups. The OAC group received 20 mg Omeprazole capsules twice a day, two 500 mg Amoxicillin capsules twice a day, and 500 mg Clarithromycin capsules twice a day for 14 days. The OAL group received 20 mg Omeprazole capsules twice a day, two 500 mg Amoxicillin capsules twice a day, and Levofloxacin 500 mg capsules twice a day for 14 days. The OAMB group received 20 mg Omeprazole capsules twice a day, two 500 mg Amoxicillin capsules twice a day, Metronidazole 500mg three times a day, and Bismuth 240 mg twice a day for 14 days. Evaluation for compliance and drug-related adverse effects were assessed at the end of two weeks. eradication was evaluated eight weeks after treatment using the C-UBT.

Results

A total of 136 patients participated in this study, and their groups were matched based on age and sex. The results of the C-UBT test showed that the eradication rate of was 82.2%, 91.3%, and 97.3% for the three-drug OAC, OAMB, and OAL treatment regimens, respectively. Moreover, all the regimens showed high compliance among the patients. Only OAC and OAL showed a significant difference in the eradication rate, and no superiority was found between OAMB and OAL or OAC therapies.

Conclusion

The regime of OAL achieved a satisfactory rate of infection eradication with good tolerance in patients with PUD, without any acute side effects.

Clinical Trial Registration Number

IRCT201605189014N100.

© 2024 Bentham Science Publishers
Loading

Article metrics loading...

/content/journals/rrct/10.2174/0115748871306001241017050020
2024-10-30
2024-11-26

  • From This Site

    /content/journals/rrct/10.2174/0115748871306001241017050020
    dcterms_title,dcterms_subject,pub_keyword
    -contentType:Contributor -contentType:Concept -contentType:Institution
    10
    5
Loading full text...

Full text loading...

References

  1. Lanas A. Chan F.K.L. Peptic ulcer disease. Lancet 2017 390 10094 613 624 10.1016/S0140‑6736(16)32404‑7 28242110
    [Google Scholar]
  2. Vakil N. Dyspepsia, peptic ulcer, and H. pylori : A remembrance of things past. Am. J. Gastroenterol. 2010 105 3 572 574 10.1038/ajg.2009.709 20203639
    [Google Scholar]
  3. Marie M.A.M. Altahir I.E. Relationship between the extent of DNA damage and gastritis in normal and Helicobacter pylori-infected patients. Gut Liver 2011 5 3 315 320 10.5009/gnl.2011.5.3.315 21927660
    [Google Scholar]
  4. Xie X. Ren K. Zhou Z. Dang C. Zhang H. The global, regional and national burden of peptic ulcer disease from 1990 to 2019: A population-based study. BMC Gastroenterol. 2022 22 1 58 10.1186/s12876‑022‑02130‑2 35144540
    [Google Scholar]
  5. Kavitt R.T. Lipowska A.M. Anyane-Yeboa A. Gralnek I.M. Diagnosis and treatment of peptic ulcer disease. Am. J. Med. 2019 132 4 447 456 10.1016/j.amjmed.2018.12.009 30611829
    [Google Scholar]
  6. Sverdén E. Agréus L. Dunn J.M. Lagergren J. Peptic ulcer disease. BMJ 2019 367 l5495 10.1136/bmj.l5495 31578179
    [Google Scholar]
  7. Mustafa M. Menon J. Muiandy R. Fredie R. Sein M. Fariz A. Risk factors, diagnosis, and management of peptic ulcer disease. IOSR J. Dent. Med. Sci. 2015 14 7 40 46
    [Google Scholar]
  8. Negash M. Wondifraw Baynes H. Geremew D. Helicobacter pylori infection and its risk factors: A prospective cross-sectional study in resource-limited settings of Northwest Ethiopia. Can J Infect Dis Med Microbiol 2018 2018 9463710 10.1155/2018/9463710
    [Google Scholar]
  9. Fischbach W. Malfertheiner P. Helicobacter pylori infection. Dtsch. Arztebl. Int. 2018 115 25 429 436 29999489
    [Google Scholar]
  10. FitzGerald R. Smith S.M. An overview of Helicobacter pylori infection. Methods Mol. Biol. 2021 2283 1 14 10.1007/978‑1‑0716‑1302‑3_1 33765303
    [Google Scholar]
  11. Crowe S.E. Helicobacter pylori infection. N. Engl. J. Med. 2019 380 12 1158 1165 10.1056/NEJMcp1710945 30893536
    [Google Scholar]
  12. Pohl D. Keller P.M. Bordier V. Wagner K. Review of current diagnostic methods and advances in Helicobacter pylori diagnostics in the era of next generation sequencing. World J. Gastroenterol. 2019 25 32 4629 4660 10.3748/wjg.v25.i32.4629 31528091
    [Google Scholar]
  13. Lee S.W. Kim H.J. Kim J.G. Treatment of Helicobacter pylori infection in Korea: A systematic review and meta-analysis. J. Korean Med. Sci. 2015 30 8 1001 1009 10.3346/jkms.2015.30.8.1001 26240475
    [Google Scholar]
  14. O’Connor A. Furuta T. Gisbert J.P. O’Morain C. Review – Treatment of Helicobacter pylori infection 2020. Helicobacter 2020 25 S1 e12743 10.1111/hel.12743 32918350
    [Google Scholar]
  15. Sharif Z. Mubashir M. Naqvi M. Atique H. Mahmood S. Ullah M. Randomized clinical trial on the efficacy of triple therapy versus sequential therapy in Helicobacter pylori eradication. Cureus 2022 14 5 e24897 10.7759/cureus.24897 35706754
    [Google Scholar]
  16. Salmanroghani H. Mirvakili M. Baghbanian M. Salmanroghani R. Sanati G. Yazdian P. Efficacy and tolerability of two quadruple regimens: Bismuth, omeprazole, metronidazole with amoxicillin or tetracycline as first-line treatment for eradication of Helicobacter pylori in patients with duodenal ulcer: A randomized clinical trial. PLoS One 2018 13 6 e0197096 10.1371/journal.pone.0197096 29889843
    [Google Scholar]
  17. Calvet X. Dealing with uncertainty in the treatment of Helicobacter pylori. Ther. Adv. Chronic Dis. 2018 9 4 93 102 10.1177/2040622318758240 29623181
    [Google Scholar]
  18. Sholeh M. Maleki F. Krutova M. Bavari S. Golmoradi R. Sadeghifard N. Amiriani T. Kouhsari E. The increasing antimicrobial resistance of Helicobacter pylori in Iran: A systematic review and meta‐analysis. Helicobacter 2020 25 5 e12730 10.1111/hel.12730 32705749
    [Google Scholar]
  19. Lopo I. Libânio D. Pita I. Dinis-Ribeiro M. Pimentel-Nunes P. Helicobacter pylori antibiotic resistance in Portugal: Systematic review and meta‐analysis. Helicobacter 2018 23 4 e12493 10.1111/hel.12493 29911329
    [Google Scholar]
  20. Peretz A. Paritsky M. Nasser O. Brodsky D. Glyatman T. Segal S. On A. Resistance of Helicobacter pylori to tetracycline, amoxicillin, clarithromycin and metronidazole in Israeli children and adults. J. Antibiot. (Tokyo) 2014 67 8 555 557 10.1038/ja.2014.38 24781955
    [Google Scholar]
  21. Hong T.C. El-Omar E.M. Kuo Y.T. Wu J.Y. Chen M.J. Chen C.C. Fang Y.J. Leow A.H.R. Lu H. Lin J.T. Tu Y.K. Yamaoka Y. Wu M.S. Liou J.M. Hong T-C. El-Omar E.M. Kuo Y-T. Wu J-Y. Chen M-J. Chen C-C. Fang Y-J. Leow A.H.R. Lu H. Lin J-T. Tu Y-K. Yamaoka Y. Wu M-S. Liou J-M. Chen Y-C. Chang Y-Y. Primary antibiotic resistance of Helicobacter pylori in the Asia-Pacific region between 1990 and 2022: An updated systematic review and meta-analysis. Lancet Gastroenterol. Hepatol. 2024 9 1 56 67 10.1016/S2468‑1253(23)00281‑9 37972625
    [Google Scholar]
  22. Valle J.D. Peptic ulcer disease and related disorders. Harrison’s Principles of Internal Medicine Loscalzo J. Fauci A. Kasper D. Hauser S. Longo D. Jameson J.L. New York, NY McGraw-Hill Education 2022
    [Google Scholar]
  23. Li B. Lan X. Wang L. Zhao J. Ding J. Ding H. Lei J. Wei Y. Zhang W. Proton-pump inhibitor and amoxicillin-based triple therapy containing clarithromycin versus metronidazole for Helicobacter pylori : A meta-analysis. Microb. Pathog. 2020 142 104075 10.1016/j.micpath.2020.104075 32074497
    [Google Scholar]
  24. Puig I. Baylina M. Sánchez-Delgado J. López-Gongora S. Suarez D. García-Iglesias P. Muñoz N. Gisbert J.P. Dacoll C. Cohen H. Calvet X. Systematic review and meta-analysis: Triple therapy combining a proton-pump inhibitor, amoxicillin and metronidazole for Helicobacter pylori first-line treatment. J. Antimicrob. Chemother. 2016 71 10 2740 2753 10.1093/jac/dkw220 27342548
    [Google Scholar]
  25. Adachi T. Matsui S. Watanabe T. Okamoto K. Okamoto A. Kono M. Yamada M. Nagai T. Komeda Y. Minaga K. Kamata K. Yamao K. Takenaka M. Asakuma Y. Sakurai T. Nishida N. Kashida H. Kudo M. Comparative study of clarithromycin- versus metronidazole-based triple therapy as first-line eradication for Helicobacter pylori. Oncology 2017 93 15 19 10.1159/000481224 29258111
    [Google Scholar]
  26. Keikha M. Askari P. Ghazvini K. Karbalaei M. Levofloxacin-based therapy as an efficient alternative for eradicating Helicobacter pylori infection in Iran: A systematic review and meta-analysis. J. Glob. Antimicrob. Resist. 2022 29 420 429 10.1016/j.jgar.2021.10.019 34788690
    [Google Scholar]
  27. Azab E.T. Thabit A.K. McKee S. Al-Qiraiqiri A. Levofloxacin versus clarithromycin for Helicobacter pylori eradication: Are 14 day regimens better than 10 day regimens? Gut Pathog. 2022 14 1 24 10.1186/s13099‑022‑00502‑3 35668511
    [Google Scholar]
  28. Cuadrado-Lavín A. Salcines-Caviedes J.R. Carrascosa M.F. Dierssen-Sotos T. Cobo M. Campos M.R. Ayestarán B. Fernández-Pousa A. González-Colominas E. Aresti-Zárate S. Hernández M. Pascual E.L. Levofloxacin versus clarithromycin in a 10 day triple therapy regimen for first-line Helicobacter pylori eradication: A single-blind randomized clinical trial. J. Antimicrob. Chemother. 2012 67 9 2254 2259 10.1093/jac/dks209 22687889
    [Google Scholar]
  29. Bang C.S. Lim H. Jeong H.M. Shin W.G. Choi J.H. Soh J.S. Kang H.S. Yang Y.J. Hong J.T. Shin S.P. Suk K.T. Lee J.J. Baik G.H. Kim D.J. Amoxicillin or tetracycline in bismuth-containing quadruple therapy as first-line treatment for Helicobacter pylori infection. Gut Microbes 2020 11 5 1314 1323 10.1080/19490976.2020.1754118 32362221
    [Google Scholar]
  30. Tian X. Suo B. Zhang H. Lu H. Li C. Zhang Y. Ren X. Yao X. Zhou L. Song Z. Bismuth, esomeprazole, metronidazole and amoxicillin or tetracycline as a first‐line regimen for Helicobacter pylori eradication: A randomized controlled trial. Helicobacter 2023 28 1 e12935 10.1111/hel.12935 36374159
    [Google Scholar]
/content/journals/rrct/10.2174/0115748871306001241017050020
Loading
The Efficacy of Two Triple Therapy Regimens and One Quadruple Regimen [Omeprazole, Amoxicillin, Metronidazole with Bismuth] in Eradicating Helicobacter Pylori in Patients with Peptic Ulcer: A Randomized Clinical Trial
Bentham Science Publishers ; https://doi.org/10.2174/0115748871306001241017050020
/content/journals/rrct/10.2174/0115748871306001241017050020
/content/journals/rrct/10.2174/0115748871306001241017050020
Loading

Data & Media loading...


  • Article Type:     Research Article
Keywords: Helicobacter pylori ; triple therapy ; randomized trial ; antimicrobial ; eradication therapy ; H. Pylori

Most Cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error
Please enter a valid_number test